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ADHD and Amphetamine

Read more about Amphetamine.

Overview

Amphetamine—along with methylphenidate—is considered to be a first-line therapy for controlling the symptoms of attention deficit hyperactivity disorder. Research shows that amphetamines are just as effective as methylphenidate for treating ADHD. The amphetamine medication for ADHD is sold under the brand names Adderall, Dexetrine, Destrostat and Vyvanse.

Effect of Amphetamine on ADHD

Amphetamines increase the synaptic activity of the dopamine and norepinephine neurotransmitters. Amphetamines stimulate the release of dopamine, block dopamine reuptake, inhibit dopamine storage and inhibit dopamine destruction.1 In addition to treating ADHD, amphetamines and dexamphetamines are commonly used to treat asthma and narcolepsy. Like methylphenidate, amphetamines are fast-acting; changes in behavior are apparent within 30 to 60 minutes after ingestion.2

Research Evidence on Amphetamine

Research suggests that amphetamine is a safe and effective treatment in reducing the symptoms of individuals with ADHD. Adolescents with ADHD treated with mixed amphetamine salts showed significant improvements to their symptoms over a four-week period. The study further concluded that the 258 subjects tolerated a single dose of up to 40 mg well.3

How to Use Amphetamine

Amphetamine is available both short- and long-acting formulas. The short-acting formulas generally work for about four hours whereas the long-acting formulas are good for the entire day. Amphetamines come in tablets and extended-release capsules. The tablets should never be chewed or crushed whereas the capsules can be broken open and sprinkled on food. The brand names for the different formulas are summarized here:

Short-acting

  • Adderall IR (IR stands for “immediate release”)
  • Dextrine
  • Dextrostat

Long-acting

  • Adderall ER (ER stands for “extended release”)
  • Dextrine SR (SR stands for “sustained release”)
  • Dextrine Spansule
  • Vyvanse

Dosages

Amphetamines are twice as strong as methylphenidate. Therefore, the minimum starting dose for children is 2.5 mg or half of what it would be for methylphenidate. The standards minimum dose for adults is 5 mg. The maximum amount of amphetamine is 40 mg versus 60 mg for methylphenidate.4

Types of Professionals That Would Be Involved with This Treatment

Medical practitioners and psychiatrists

Side Effects and Warnings

Amphetamine is highly addictive and should only be used under the careful supervision of a qualified physician. Amphetamine-based stimulant medications are also more likely to cause a loss of appetite and weight loss than methylphenidate-based medications. Amphetamines can also be deadly when combined with monoamine oxidase inhibitors, a type of antidepressant.

Like all stimulant medications, amphetamine and dextroamphetamine can cause sleeplessness, loss and appetite and weight loss. Other common side effects include the following:

  • Constipation;
  • Diarrhea;
  • Dizziness;
  • Dry mouth;
  • Headache;
  • Nausea;
  • Nervousness;
  • Restlessness; and
  • Stomach pain.

Other more severe side effects include the following:

  • Allergic reactions;
  • Blurred vision;
  • Change in libido;
  • Chest pain;
  • Confusion;
  • Depression;
  • Fever;
  • Irregular heartbeat;
  • Moodiness;
  • Numbness or tingling in one arm;
  • One-sided weakness;
  • Painful or frequent urination;
  • Seizures;
  • Slurred speech; and
  • Uncontrolled muscle movements.5

Amphetamine versus methylphenidate

Few studies have compared the efficacy of methylphenidate and amphetamine in the treatment of ADHD. Although methylphenidate is generally recommended first, some researchers believe that both medications should be tried prior to one or the other being chosen. It’s not uncommon for some individuals to respond better to amphetamine than methylphenidate and vice versa.6

References

  1. “Amphetamines,” Neuroscience for Kids. http://faculty.washington.edu/chudler/amp.html
  2. Stephen W. Garber, Ph.D., Marianne Daniels Garber Ph.D., and Robyn Freedman Spizman, Beyond Ritalin (New York: Villard Books, 1996): 93.
  3. Thomas Spencer, et al. “Efficacy and safety of mixed amphetamine salts extended release (Adderall XR) in the management of attention-deficit/hyperactivity disorder in adolescent patients: a 4-week, randomized, double-blind, placebo-controlled, parallel-group study,” Clinical Therapy 28, no. 2 (February 2006): 266–279.
  4. Thomas E. Brown, Ph.D., Attention Deficit Disorder: The Unfocused Mind in Children and Adults, (New Haven and London: Yale University Press, 2005): 256–258.
  5. Amphetamine Side Effects,” Drugs.com, http://www.drugs.com/sfx/amphetamine-side-effects.html
  6. Stephen W. Garber, Ph.D., Marianne Daniels Garber Ph.D., and Robyn Freedman Spizman, Beyond Ritalin (New York: Villard Books, 1996): 93.

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